Qualifications:

• High School Diploma or Associates Degree
• Insurance and Billing Certificate helpful
• 2 years of Coding experience in Optical preferred or Healthcare
• Strong working knowledge of Microsoft Office (Excel, Word, Outlook, Nextech, FlexSystem and Trizetto (preferred)
• 1-2 years of experience in billing and reimbursement for commercial insurance, Medicare and Medicaid

Responsibilities:

• Responsible for any or all aspects of the medical claims and billing process for Whitewater Eye Centers
• Review claims to ensure billing requirements have been met and provide follow-up on any denials, apply adjustments, answer inquiries and update accounts as necessary
• Identify and resolve inquiries from patients, staff and commercial and government payers
• Determine insurance eligibility for patients and assist with referral issues
• Work claims for submission through the clearinghouse and following up on all insurance carrier guidelines
• File electronic Medicaid claims in accordance with state Medicaid rules
• Perform Surgery billing and apply modifiers per Correct Coding Initiative
• Prioritize high dollar denied claims and appeals in aging report
• Maintain and review aging reports and take action on overdue accounts
• Apply Medicare LCD Articles as appropriate to claims and appeals
• Maintain confidentiality and strictly follow HIPAA and regulatory guidelines
• Follow Whitewater Eye Centers customer service guidelines and culture

Hours:

• Full and part time positions
• Remote opportunities